Individual
MS. SANDRA HALL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
310 W. PORTER AVE, OCEAN SPRINGS, MS 39564
(228) 872-2011
(228) 872-3791
Mailing address
310 W. PORTER AVE, OCEAN SPRINGS, MS 39564
(228) 872-2011
(228) 872-3791
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C1885
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118148
—
MS
01
—
62-51970
MAIL HANDLERS BENEFIT PLA
MS
01
—
C1885
MS STATE LICENSE
MS
01
—
SWL-3703000
AMERICAN PROFESSIONAL AGE
NY
Enumeration date
10/17/2006
Last updated
05/06/2013
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